Vol 7 - Issue 1 : June 2022
Pure and Applied Science

Effect of COVID-19 on Severity of Signs and Symptoms of Autoimmune Diseases

Ramand Mohammed Haji
Sulaimani Polytechnic University
Nabaz Ali Ahmed
Raparin University-College of Nursing
Shakhawan Azad Ahmed
Raparin University-College of Nursing

Published 25-04-2022


  • COVID-19,
  • Autoimmune Diseases,
  • Signs and Symptoms

How to Cite

“Effect of COVID-19 on Severity of Signs and Symptoms of Autoimmune Diseases”, KJAR, pp. 37–44, Apr. 2022, doi: 10.24017/Science.2022.1.4.


It is an observational cross-sectional study, the data collected by convenience sampling method from 33 patients in the Ranya General Hospital and private clinics for follow-up patient’s autoimmune diseases state in the Ranya city from the 10th November 2020 to the 20th May 2021 and the study included all the patients had autoimmune diseases that recovered from the COVID-19 disease. For the study materials, the data was collected by a questionnaire form that included demographic and autoimmune disease questions also questions about the patient’s intensity of their autoimmune disease’s signs and symptoms before and after they recovered from COVID-19. Determine patient’s autoimmune disease signs and symptoms intensity based on the prescribed drug for a treat the autoimmune diseases which are changed by special doctors. Furthermore, the data were analysed by SPSS software to produce descriptive statistic measures and to find the difference between dependent categorical variables Sign tests were used but the Chi-square test was used for the categorical independent variables with regarding 0.05 as a significant critical value. The result reveals that the range of their age started from 42 to 74 years old with mean±standard deviation (57.3 ± 8.06) and most of the cases 15(45.5%) were between (55-65) years old, followed by less than 55 years old 13(39.4%) and more than 65 years old age 5(3.8%) cases respectively. Rheumatoid arthritis was a major type 16 (48.5%) of the autoimmune disease compared to other types, Ankylosing Spondylitis 8(24.2%) cases, and Ulcerative Colitis 6(18.2%) cases respectively while Crohn's disease was the minimum 3(9.1%) cases and before the got COVID-19 most of the cases 25(75.8%) had moderate intensity signs and symptoms of their autoimmune diseases and 8(24.2%) cases had severe signs and symptoms but after they recovered from the COVID-19 disease the rate of their signs and symptoms changed to mild 19(57.6%) and moderate 14(42.4%) intensity while severe intensity signs and symptoms were zero with highly significant differences (P-value 0.0001). Despite the current study concluded autoimmune disease patients recovered from the COVID-19 their autoimmune diseases signs and symptoms intensity decreased significantly but still further studies are needed with a bigger sample size to determine and explain this association.


[1] T. Struyf, J. J. Deeks, J. Dinnes, Y. Takwoingi, C. Davenport, M. M. Leeflang, et al., "Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID?19," Cochrane Database of Systematic Reviews, 2021.
[2] E. J. Williamson, A. J. Walker, K. Bhaskaran, S. Bacon, C. Bates, C. E. Morton, et al., "OpenSAFELY: factors associated with COVID-19 death in 17 million patients," Nature, vol. 584, p. 430, 2020.
[3] A. Floreani, P. S. Leung, and M. E. Gershwin, "Environmental basis of autoimmunity," Clinical reviews in allergy & immunology, vol. 50, pp. 287-300, 2016.
[4] H. M. Hussein and E. A. Rahal, "The role of viral infections in the development of autoimmune diseases," Critical reviews in microbiology, vol. 45, pp. 394-412, 2019.
[5] L. Wang, F. S. Wang, and M. E. Gershwin, "Human autoimmune diseases: a comprehensive update," Journal of internal medicine, vol. 278, pp. 369-395, 2015.
[6] A. Ercolini and S. Miller, "The role of infections in autoimmune disease," Clinical & Experimental Immunology, vol. 155, pp. 1-15, 2009.
[7] Fujinami, R., von Herrath, M., Christen, U. and Whitton, J., 2006. Molecular Mimicry, Bystander Activation, or Viral Persistence: Infections and Autoimmune Disease. Clinical Microbiology Reviews, 19(1), pp.80-94.
[8] N. Rose and I.Mackay, The Autoimmune Diseases, 6th: Elsevier Science & Technology, 2019.
[9] Y. Liu, A. H. Sawalha, and Q. Lu, "COVID-19 and autoimmune diseases," Current Opinion in Rheumatology, vol. 33, p. 155, 2021.
[10] M. Wang, R. Cao, L. Zhang, X. Yang, J. Liu, M. Xu, et al., "Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro," Cell research, vol. 30, pp. 269-271, 2020.
[11] G. Figueroa-Parra, G. M. Aguirre-Garcia, C. M. Gamboa-Alonso, A. Camacho-Ortiz, and D. A. GalarzaDelgado, "Are my patients with rheumatic diseases at higher risk of COVID-19?," Annals of the rheumatic diseases, vol. 79, pp. 839-840, 2020.
[12] A. Druyan, M. Lidar, M. Brodavka, I. Levy, A. Barzilai, and F. Pavlotsky, "The risk for severe COVID 19 in patients with autoimmune and/or inflammatory diseases: First wave lessons," Dermatologic Therapy, vol. 34, p. e14627, 2021.
[13] D. Kanduc and Y. Shoenfeld, "On the molecular determinants of the SARS-CoV-2 attack," Clinical Immunology (Orlando, Fla.), vol. 215, p. 108426, 2020.
[14] M. Ayala Gutiérrez, M. Rubio-Rivas, C. Romero Gómez, A. Montero Sáez, I. Pérez de Pedro, N. Homs, et al., "Autoimmune Diseases and COVID-19 as Risk Factors for Poor Outcomes: Data on 13,940 Hospitalized Patients from the Spanish Nationwide SEMI-COVID-19 Registry," Journal of clinical medicine, vol. 10, p. 1844, 2021.
[15] J. Finsterer, F. Scorza, and A. Fiorini, "SARS?CoV?2 associated Guillain?Barre syndrome in 62 patients," European journal of neurology, 2020.
[16] R. Bonometti, M. Sacchi, P. Stobbione, E. Lauritano, S. Tamiazzo, A. Marchegiani, et al., "The first case of systemic lupus erythematosus (SLE) triggered by COVID-19 infection," Eur Rev Med Pharmacol Sci, vol. 24, pp. 9695-9697, 2020.
[17] F. Caso, L. Costa, P. Ruscitti, L. Navarini, A. Del Puente, R. Giacomelli, et al., "Could Sars-coronavirus-2 trigger autoimmune and/or autoinflammatory mechanisms in genetically predisposed subjects?," Autoimmunity reviews, vol. 19, p. 102524, 2020.
[18] V. Zinserling, M. Vashukova, M. Vasilyeva, A. Isakov, N. Lugovskaya, T. Narkevich, et al., "Issues of pathology of a new coronavirus infection CoVID-19," Jurnal Infektologii, vol. 12, 2020.
[19] C. Konya, J. J. Goronzy, and C. M. Weyand, "Treating autoimmune disease by targeting CD8+ T suppressor cells," Expert opinion on biological therapy, vol. 9, pp. 951-965, 2009.